Man eats himself into intensive care unit

2022-04-28 0 By

On weekdays, I tend to eat greasy food, and my life is irregular.Chinese New Year is the time to start binge eating.On February 7, the 37-year-old man, surnamed Li, came to wuhan No. 3 Hospital for treatment after suffering a sudden abdominal pain and discomfort that could not be relieved by taking medication on his own.The nurse in the emergency department measured Mr. Li’s random blood glucose, and the value was High(>33.3mmol/L). When blood was collected, the venous blood collected from Mr. Li was chylous, indicating extremely High blood lipids (total cholesterol 17.18mmol/L, triglyceride 31.41mmol/L).Pancreatin increased significantly (lipase 946U/L, amylase 480U/L), and emergency CT suggested pancreatic swelling accompanied by inflammatory exudation, which was considered as acute pancreatitis.According to Mr. Li, this was the second time he suffered from pancreatitis. He had also seen a doctor before because of abdominal pain, vomiting and discomfort. During the treatment, his condition progressed and multiple organ dysfunction occurred.It is also the onset of pancreatitis, resulting in Mr. Li suffered from diabetes.Dong Fang, director of the Intensive care Medicine department of The Shouyi Hospital of Wuhan Third Hospital, said that acute pancreatitis refers to the acute abdomen caused by abnormal activation of pancreatic enzyme, which is mainly characterized by local inflammatory reaction of the pancreas and can even lead to organ dysfunction.There are many causes of acute pancreatitis. In China, cholelithiasis is still the main cause of acute pancreatitis, followed by hypertriglyceridemia and excessive drinking.Among them, hypertriglyceridemia and alcoholic acute pancreatitis are more common in young men.Its typical symptom is acute break out persistent upper abdomen is intense ache, often radiate to back, companion has abdominal distension, disgusting, vomit, and the ache after vomiting is not alleviated, partial patient can appear tachycardia, dyspnea, little urine, mental state changes wait for expression.The severity of acute pancreatitis is mainly divided into three levels, mild acute pancreatitis, severe acute pancreatitis, severe acute pancreatitis.Among them, severe acute pancreatitis accounts for 5%-10% of acute pancreatitis, with persistent organ dysfunction (>48 h) and high mortality. Therefore, early identification and more active monitoring and treatment measures should be taken for patients who may progress to severe pancreatitis, which is conducive to improving the overall prognosis of patients.The treatment principles of acute pancreatitis mainly include fluid therapy, analgesia and nutritional support, as well as treatment for etiology and early complications.In patients with SAP, hemodynamic status should be repeatedly evaluated during fluid therapy to avoid tissue edema and apparatus resulting from fluid overload, such as low-dose low molecular weight heparin, insulin, lipid adsorption, and/or plasma exchange.Long-term hyperlipidemia and excessive drinking caused Mr. Li to suffer from acute pancreatitis again. During hospitalization, he also suffered from dyspnea, oliguria and other organ dysfunction, which met the diagnostic criteria for severe acute inflammation.After the early fasting water, gastrointestinal decompression, acid inhibition and enzyme inhibition, drugs to reduce blood lipids, plasma exchange and other positive treatment measures.The blood lipid of the patient quickly decreased to normal levels (total cholesterol 2.83mmol/L, triglyceride 1.99mmol/L), and various indicators were significantly improved. The symptoms of abdominal pain, abdominal distension and panting were significantly relieved. Within 1 week, the patient was transferred to the general ward for follow-up treatment.Doctors remind: holidays are often the period of high incidence of acute pancreatitis, for patients with hyperlipidemia, through low-fat diet and weight loss after lipid control is still poor, need oral lipid-lowering drugs treatment;Abstinence is an important treatment for alcoholic acute pancreatitis. Even short-term abstinence after admission can prevent recurrent episodes of alcoholic acute pancreatitis.(Reporter: Wei Wei, Correspondent: Chen Shu)